Trust deficit causes vaccine hesitancy

In remote villages of Husainabad block of Palamau district of Jharkhand, most people have heard of some disease called Corona, but do not know anyone personally who got infected. A recent field study by local civil society indicated that most believe it to be a ‘shahri bimari’ (urban disease). Hence, the need for vaccination does not arise. Some others fear that the vaccine may cause sickness, as those who got a jab had shown signs of vomiting and fever (even though for a few days).

In Chandauli and Sitapur districts of UP, however, the hesitancy about the vaccine was less to do with myths or misinformation, and more to do with fears. Some villagers feel that vaccination may cause infertility; some think women’s menstruation cycle may get disturbed and obstruct future pregnancy. Some mentioned that vaccination for elderly is designed to get rid of them. When local field workers tried to reason that there is no basis for such information, some locals said that they did not want to share their identity card for fear of misuse by vaccinating authority.

It is not just the rural population which is showing vaccine hesitancy in the country. Studies have shown that urban informal workers (like maids, drivers, construction workers, etc.) are hesitant to take the jab for fear of getting ‘infected’ through the ‘live’ virus in the vaccine, and then being ‘labelled’ as corona patient, forced to quarantine. This may cause loss of livelihood for them and their families. It may appear as if vaccine hesitancy is mostly amongst the poor communities. However, vaccine hesitancy was found amongst medical students (nearly 10% of those surveyed) and amongst frontline health care workers (nearly 20% did not get a jab till June 2021). For them, the main reason for hesitancy was lack of trust in the efficacy and safety of vaccine itself, especially Covaxin, since it was under trial till recently.

The phenomenon of vaccine hesitancy is global. Nearly 30% nurses in Israel and Hong Kong too were not getting vaccinated. In countries where vaccination began last year itself, hesitancy was shown in nearly 40-50% of population in European countries and Russia. Most were concerned about the safety of the vaccine.

Despite strong country-wide push for vaccination in America after the new President Biden took charge in January 2021, many people in southern states (mostly Republican voters) of America have no interest in vaccination. Many do not even believe there is a pandemic. Even though nearly half of the American adult population has been vaccinated, others continue to resist and even ignore vaccination, though available readily and freely.

Many campaigns of information about the virus and vaccination have been launched across the world, and in India too. Top political leaders have repeatedly appealed for vaccination in India. Despite some uneven availability, supply of vaccines is not a real deterrent. So, why people in Chandauli and Sitapur are afraid to get vaccinated?

Authentic information is essential for behaviour change communication. Such information, howsoever authentic, needs to be received from a trusted source. Many a times, such trusted sources are local community leaders and social activists. Mass communication on its own does not lead to ‘unlearning’ old attitudes, prejudices and myths; more personalised communication matters a great deal. Learning new ways of behaving, therefore, entails interactions with trusted others. This is where local civil society is essential to play this critical role through community leaders and animators.

Fear is also linked to lack of trust in public authorities. Trust deficit in public institutions and authorities is directly a result of ways in which certain governments and their leaders have been behaving lately. Denial of ground realities of suffering of people due to the pandemic emboldens people to continue their belief that the virus is a myth. Introducing punitive measures against those who speak ground realities re-affirms fears that some things must be terribly wrong that is why authorities are silencing such voices. Announcing policies like population control in the midst of the vaccination drive reinforces fears about some ‘hidden’ motive for it.

In any case, trust deficit between ordinary citizens and public authorities, institutions and political leaders has been generally high in past few years, not just in India. Therefore, actions to reduce such trust deficit will contribute to reducing fears of people, thereby reducing vaccine hesitancy. What actions will be appropriate in this regard?